Computer-based pattern recognition is routinely used to interpret imaging data and other diagnostic procedures. The use of noninvasive imaging technologies has substantially increased. Diagnosis almost always involves collaboration between a human physician and a pattern-recognition-based expert system. Doctors routinely consult knowledge-based systems (generally through two-way voice communication augmented by visual displays), which provide automated guidance, access to the most recent medical research, and practice guidelines.
Lifetime patient records are maintained in computer databases. Privacy concerns about access to these records (as with many other databases of personal information) have emerged as a major issue.
Doctors routinely train in virtual reality environments, which include a haptic interface. These systems simulate the visual, auditory, and tactile experience of medical procedures, including surgery. Simulated patients are available for continuing medical education, for medical students, and for people who just want to play doctor.
Philosophy
There is renewed interest in the Turing Test, first proposed by Alan Turing in 1950 as a means for testing intelligence in a machine. Recall that the Turing Test contemplates a situation in which a human judge interviews the computer and a human “foil,” communicating with both over terminal lines. If the human judge is unable to tell which interviewee is human and which is machine, the machine is deemed to possess human-level intelligence. Although computers still fail the test, confidence is increasing that they will be in a position to pass it within another one or two decades.
There is serious speculation on the potential sentience (that is, consciousness) of computer-based intelligence. The increasingly apparent intelligence of computers has spurred an interest in philosophy.
... Hey, Molly.
OH, SO YOU’RE CALLING ME NOW.
Well, the chapter was over and I didn’t hear from you.
I’M SORRY, I WAS FINISHING UP A PHONE CALL WITH MY FIANCE.
Hey, congratulations, that’s great. How long have you known ...
BEN, HIS NAME IS BEN. WE MET ABOUT TEN YEARS AGO, JUST AFTER YOU FINISHED THIS BOOK.
I see. So how have I done?
YOU DID MANAGE TO SELL A FEW COPIES.
No, I mean with my predictions.
NOT VERY WELL. THE TRANSLATING TELEPHONES, FOR ONE THING, ARE A LITTLE RIDICULOUS. I MEAN, THEY’RE CONSTANTLY SCREWING UP.
Sounds like you use them, though?
WELL, SURE, HOW ELSE AM I GOING TO SPEAK TO MY FIANCÉ’S FATHER IN IEPER, BELGIUM, WHEN HE HASN’T BOTHERED TO LEARN ENGLISH?
Of course. So what else?
YOU SAID THAT CANCER WAS REDUCED, BUT THAT’S ACTUALLY QUITE UNDERSTATED. BIOENGINEERED TREATMENTS, PARTICULARLY ANTIANGIOGENESIS DRUGS THAT PREVENT TUMORS FROM GROWING THE CAPILLARIES THEY NEED, HAVE ELIMINATED MOST FORMS OF CANCER AS A MAJOR KILLER. 6
Well, that’s just not a prediction I was willing to make. There have been so many false hopes with regard to cancer treatments, and so many promising approaches proving to be dead ends, that I just wasn’t willing to make that call. Also, there just wasn’t enough evidence when I wrote the book in 1998 to make that dramatic a prediction.
NOT THAT YOU SHIED AWAY FROM DRAMATIC PREDICTIONS.
The predictions I made were fairly conservative, actually, and were based on technologies and trends I could touch and feel. I was certainly aware of several promising approaches to bioengineered cancer treatments, but it was still kind of iffy, given the history of cancer research. Anyway, the book only touched tangentially on bioengineering, although it’s clearly an information-based technology.
NOW WITH REGARD TO SEX—
Speaking of health problems ...
YES, WELL, YOU SAID THAT VIRTUAL PARTNERS WERE POPULAR, BUT I JUST DON’T SEE THAT.
It might just be the circle you move in.
I HAVE A VERY SMALL CIRCLE—MOSTLY I’VE BEEN TRYING TO GET BEN TO FOCUS ON OUR WEDDING.
Yes, tell me about him.
HE’S VERY ROMANTIC. HE ACTUALLY SENDS ME LETTERS ON PAPER!
That is romantic. So, how was the phone call I interrupted?
I TRIED ON THIS NEW NIGHTGOWN HE SENT ME. I THOUGHT HE’D APPRECIATE IT, BUT HE WAS BEING A LITTLE ANNOYING.
I assume you’re going to finish that thought.
WELL, HE WANTED ME TO KIND OF LET THESE STRAPS SLIP, MAYBE JUST A LITTLE. BUT I’M KIND OF SHY ON THE PHONE. I DON’T REALLY GO IN FOR VIDEO PHONE SEX, NOT LIKE SOME FRIENDS I KNOW.
Oh, so I did get that prediction right.
ANYWAY, I JUST TOLD HIM TO USE THE IMAGE TRANSFORMERS.
Transformers?
YOU KNOW, HE CAN UNDRESS ME JUST AT HIS END.
Oh yes, of course. The computer is altering your image in real time.
EXACTLY. YOU CAN CHANGE SOMEONE’S FACE, BODY, CLOTHING, OR SURROUNDINGS INTO SOMEONE OR SOMETHING ELSE ENTIRELY, AND THEY DON’T KNOW YOU’RE DOING IT.
Hmmm.
ANYWAY, I CAUGHT BEN UNDRESSING HIS OLD GIRLFRIEND WHEN SHE CALLED TO CONGRATULATE HIM ON OUR ENGAGEMENT. SHE HAD NO IDEA, AND HE THOUGHT IT WAS HARMLESS. I DIDN’T SPEAK TO HIM FOR A WEEK.
Well, as long as it was just at his end.
WHO KNOWS WHAT SHE WAS DOING AT HER END.
That’s kind of her business, isn’t it? As long as they don’t know what the other is doing.
I’M NOT SO SURE THEY DIDN’T KNOW ANYWAY, PEOPLE DO SPEND A LOT OF TIME TOGETHER UP CLOSE BUT AT A DISTANCE, IF YOU KNOW WHAT I MEAN.
Using the displays?
WE CALL THEM PORTALS—YOU CAN LOOK THROUGH THEM, BUT YOU CAN’T TOUCH.
I see, still no interest in virtual sex?
NOT PERSONALLY. I MEAN, IT’S PRETTY PATHETIC. BUT I DID HAVE TO WRITE THE COPY FOR A BROCHURE ABOUT A SENSUAL VIRTUAL REALITY ENVIRONMENT. BEING LOW ON THE TOTEM POLE, I REALLY CAN’T PICK MY ASSIGNMENTS.
Did you try the product?
I DIDN’T EXACTLY TRY IT. I JUST OBSERVED. I WOULD SAY THEY PUT MORE EFFORT INTO THE VIRTUAL GIRLS THAN THE GUYS.
How’d your campaign make out?
THE PRODUCT BOMBED. I MEAN, THE MARKET’S JUST SO CLUTTERED.
You can’t win them all.
NO, BUT ONE OF YOUR PREDICTIONS DID WORK OUT QUITE WELL. I TOOK YOUR ADVICE ABOUT THAT COMPANY NORTH OF THE MASON-DIXON LINE. AND, HEY, I’M NOT COMPLAINING.
I’ll bet a lot of stocks are up.
YES, THE BOATS KEEP GETTING HIGHER.
Okay, what else?
YOU’RE RIGHT ABOUT THE DISABLED. MY OFFICE MATE IS DEAF, AND IT’S NOT AN ISSUE AT ALL. THERE’S NOTHING IMPORTANT A BLIND OR DEAF PERSON CAN’T DO TODAY.
That was really true back in 1999.
I THINK THE DIFFERENCE NOW IS THAT THE PUBLIC UNDERSTANDS IT. IT’S JUST A LOT MORE OBVIOUS WITH TODAY’S TECHNOLOGY. BUT THAT UNDERSTANDING IS IMPORTANT.
Sure, without the technology, there’s just a lot of misconception and prejudice.
TRUE ENOUGH. I THINK I’M GOING TO HAVE TO GET GOING, I CAN SEE BEN’S FACE ON MY CALL LINE.
He looks like a St. Bernard.
OH, I LEFT MY IMAGE TRANSFORMERS ON. HERE, I’LL LET YOU SEE WHAT HE REALLY LOOKS LIKE.
Hey, good-looking guy. Well, good luck. You do seem to have changed.
I SHOULD HOPE SO.
I mean I think our relationship has changed.
WELL, I’M TEN YEARS OLDER.
And it seems that I’m asking you most of the questions.
I GUESS I’M THE EXPERT NOW. I CAN JUST TELL YOU WHAT I SEE. BUT HOW COME YOU’RE STILL STUCK IN 1999?
I’m afraid I just can’t leave quite yet. I have to get this book out, for one thing.
I DO HAVE ONE CONFUSION. HOW IS IT THAT YOU CAN TALK TO ME FROM 1999 WHEN I’M HERE IN THE YEAR 2009? WHAT KIND OF TECHNOLOGY IS THAT?
Oh, that’s a very old technology. It’s called poetic license.
CHAPTER TEN
2019
He who mounts a wild elephant goes where the wild elephant goes.
 
; —Randolph Bourne
It does not do you good to leave a dragon out of your calculations, if you live near him.
—J.R.R. Tolkien
The Computer Itself
Computers are now largely invisible. They are embedded everywhere—in walls, tables, chairs, desks, clothing, jewelry, and bodies.
People routinely use three-dimensional displays built into their glasses,1 or contact lenses. These “direct eye” displays create highly realistic, virtual visual environments overlaying the “real” environment. This display technology projects images directly onto the human retina, exceeds the resolution of human vision, and is widely used regardless of visual impairment. The direct-eye displays operate in three modes:
1. Head-directed display: The displayed images are stationary with respect to the position and orientation of your head. When you move your head, the display moves relative to the real environment. This mode is often used to interact with virtual documents.
2. Virtual-reality overlay display: The displayed images slide when you move or turn your head so that the virtual people, objects, and environment appear to remain stationary in relation to the real environment (which you can still see). Thus if the direct-eye display is displaying the image of a person (who could be a geographically remote real person engaging in a three-dimensional visual phone call with you, or a computer-generated “simulated” person), that projected person will appear to be in a particular place relative to the real environment that you also see. When you move your head, that projected person will appear to remain in the same place relative to the real environment.
3. Virtual-reality blocking display: This is the same as the virtual-reality overlay display except that the real environment is blocked out, so you see only the projected virtual environment. You use this mode to leave “real” reality and enter a virtual reality environment.
In addition to the optical lenses, there are auditory “lenses,” which place high-resolution sounds in precise locations in a three-dimensional environment. These can be built into eyeglasses, worn as body jewelry, or implanted in the ear canal.
Keyboards are rare, although they still exist. Most interaction with computing is through gestures using hands, fingers, and facial expressions and through two-way natural-language spoken communication. People communicate with computers the same way they would communicate with a human assistant, both verbally and through visual expression. Significant attention is paid to the personality of computer-based personal assistants, with many choices available. Users can model the personality of their intelligent assistants on actual persons, including themselves, or select a combination of traits from a variety of both public personalities and private friends and associates.
Typically, people do not own just one specific “personal computer,” although computing is nonetheless very personal. Computing and extremely-high-bandwidth communication are embedded everywhere. Cables have largely disappeared.
The computational capacity of a $4,000 computing device (in 1999 dollars) is approximately equal to the computational capability of the human brain (20 million billion calculations per second).2 Of the total computing capacity of the human species (that is, all human brains) combined with the computing technology the species has created, more than 10 percent is nonhuman.3
Rotating memories and other electromechanical computing devices have been fully replaced with electronic devices. Three-dimensional nanotube lattices are now a prevalent form of computing circuitry.
The majority of “computes” of computers are now devoted to massively parallel neural nets and genetic algorithms.
Significant progress has been made in the scanning-based reverse engineering of the human brain. It is now fully recognized that the brain comprises many specialized regions, each with its own topology and architecture of interneuronal connections. The massively parallel algorithms are beginning to be understood, and these results have been applied to the design of machine-based neural nets. It is recognized that the human genetic code does not specify the precise interneuronal wiring of any of the regions, but rather sets up a rapid evolutionary process in which connections are established and fight for survival. The standard process for wiring machine-based neural nets uses a similar genetic evolutionary algorithm.
A new computer-controlled optical-imaging technology using quantum-based diffraction devices has replaced most lenses with tiny devices that can detect light waves from any angle. These pinhead-sized cameras are everywhere.
Autonomous nanoengineered machines can control their own mobility and include significant computational engines. These microscopic machines are beginning to be applied to commercial applications, particularly in manufacturing and process control, but are not yet in the mainstream.
Education
Hand-held displays are extremely thin, very high resolution, and weigh only ounces. People read documents either on the hand-held displays or, more commonly, from text that is projected into the ever present virtual environment using the ubiquitous direct-eye displays. Paper books and documents are rarely used or accessed. Most twentieth-century paper documents of interest have been scanned and are available through the wireless network.
Most learning is accomplished using intelligent software-based simulated teachers. To the extent that teaching is done by human teachers, the human teachers are often not in the local vicinity of the student. The teachers are viewed more as mentors and counselors than as sources of learning and knowledge.
Students continue to gather together to exchange ideas and to socialize, although even this gathering is often physically and geographically remote.
All students use computation. Computation in general is everywhere, so a student’s not having a computer is rarely an issue.
Most adult human workers spend the majority of their time acquiring new skills and knowledge.
Disabilities
Blind persons routinely use eyeglass-mounted reading-navigation systems, which incorporate the new, digitally controlled, high-resolution optical sensors. These systems can read text in the real world, although since most print is now electronic, print-to-speech reading is less of a requirement. The navigation function of these systems, which emerged about ten years ago, is now perfected. These automated reading-navigation assistants communicate to blind users through both speech and tactile indicators. These systems are also widely used by sighted persons since they provide a high-resolution interpretation of the visual world.
Retinal and vision neural implants have emerged but have limitations and are used by only a small percentage of blind persons.
Deaf persons routinely read what other people are saying through the deaf persons’ lens displays. There are systems that provide visual and tactile interpretations of other auditory experiences such as music, but there is debate regarding the extent to which these systems provide an experience comparable to that of a hearing person. Cochlear and other implants for improving hearing are very effective and are widely used.
Paraplegic and some quadriplegic persons routinely walk and climb stairs through a combination of computer-controlled nerve stimulation and exoskeletal robotic devices.
Generally, disabilities such as blindness, deafness, and paraplegia are not noticeable and are not regarded as significant.
Communication
You can do virtually anything with anyone regardless of physical proximity. The technology to accomplish this is easy to use and ever present.
“Phone” calls routinely include high-resolution three-dimensional images projected through the direct-eye displays and auditory lenses. Three-dimensional holography displays have also emerged. In either case, users feel as if they are physically near the other person. The resolution equals or exceeds optimal human visual acuity Thus a person can be fooled as to whether or not another person is physically present or is being projected through electronic communication. The majority of “meetings” do not require physical proximity.